Neurosurgical apparatus and method

Abstract

A method for delivering fluid to the brain of a subject using an intraparenchymal catheter, the method comprising the step of inserting the catheter 5 into the brain using a posterior to anterior approach and methods of treating neurodegenerative disorders using this delivery method, as well as methods for delivering fluid to an elongate structure of the brain using an intraparenchymal catheter, the method comprising the step of inserting a catheter into the brain along an insertion axis that is substantially aligned with a long axis of the elongate structure.

What is claimed is: 
     
       1. A method for intraparenchymal delivery of a fluid to an elongate structure of a brain of a subject, the method comprising delivering the fluid to the elongate structure by inserting at least one intraparenchymal catheter having at least one step into the brain using a posterior to anterior approach along an insertion axis that is substantially aligned with a long axis of the elongate structure, such that said at least one step is located within said elongate structure and fluid will reflux from a tip of said catheter to said step and deliver more fluid to said elongate structure than a method without said at least one step located within said elongate structure. 
     
     
       2. The method of  claim 1 , wherein the insertion axis is aligned with the long axis of the elongate structure to within 40° or less. 
     
     
       3. The method of  claim 1 , wherein the catheter is inserted into a posterior portion of the elongate structure along the long axis to an anterior portion of the elongate structure. 
     
     
       4. The method of  claim 1 , wherein the subject is under general anesthetic and in a prone position. 
     
     
       5. The method of  claim 1 , wherein the fluid includes at least one therapeutic agent selected from the group consisting of a chemotherapy drug, a neurotrophin, an enzyme, a growth factor, an antibody, an immunotoxin, small inhibitory RNA (siRNA), antisense oligonucleotides, viral vectors, drug releasing nanoparticles, and transgenes. 
     
     
       6. A method for treating a neurodegenerative disorder, the method comprising delivering a fluid to the brain by inserting at least one intraparenchymal catheter having at least one step into a target volume of the brain using a posterior to anterior approach along an insertion axis that is substantially aligned with a long axis of the target volume such that said at least one step is located within said target volume and said fluid will reflux from a tip of said catheter to said at least one step and deliver more fluid to said elongate structure than a method without said at least one step located within said elongate structure. 
     
     
       7. The method of  claim 6 , wherein the insertion axis is aligned with the long axis of the target volume to within 40° or less. 
     
     
       8. The method of  claim 6 , wherein the catheter is inserted into a posterior portion of the target volume along the long axis to an anterior portion of the target volume. 
     
     
       9. The method of  claim 6 , wherein the subject is under general anesthetic and in a prone position. 
     
     
       10. The method of  claim 6 , wherein the target volume is an elongate structure of the brain. 
     
     
       11. The method of  claim 6 , wherein the neurodegenerative disorder is at least one of Multiple-System Atrophy, Progressive Supranuclear Palsy (PSP), Parkinson's Disease, Huntington's Disease, dystonia, tremor, Tourette's syndrome and lysosomal storage diseases. 
     
     
       12. The method of  claim 6 , wherein the fluid includes at least one therapeutic agent selected from the group consisting of a chemotherapy drug, a neurotrophin, an enzyme, a growth factor, an antibody, an immunotoxin, small inhibitory RNA (siRNA), antisense oligonucleotides, viral vectors, drug releasing nanoparticles, and transgenes. 
     
     
       13. A method for treating Huntington's disease, the method comprising delivering a fluid comprising a transgene to the brain by inserting at least one catheter having at least one step into an elongate structure of the brain using a posterior to anterior approach along an insertion axis that is substantially aligned with a long axis of the elongate structure,
 wherein the elongate structure is selected from the head of caudate nucleus and the putamen, and wherein the at least one step is located within the elongate structure and said fluid will reflux from a tip of said catheter to said at least one step and deliver more fluid to said elongate structure than a method without said at least one step located within said elongate structure. 
 
     
     
       14. The method of  claim 13 , wherein the catheter is an intraparenchymal catheter. 
     
     
       15. The method of  claim 13 , wherein the insertion axis is aligned with the long axis of the target volume to within 40° or less.